Tag: Ghana

Another Fairly Insane Cross-National Health Care Comparison

Yesterday, countless newspapers published a really disappointing story by Noam Levey that the Los Angeles Times ran under this title:

Global push to guarantee health coverage leaves U.S. behind; China, Mexico and other countries far less affluent are working to provide medical insurance for all citizens. It’s viewed as an economic investment.

The article is little more than a puff piece for the hotly contested idea of universal coverage. It gives zero space to the competing strain of thought that the less the government does for the poor, the sick, and the vulnerable, the better off they will be.

It quotes “Dr. Julio Frenk, a former health minister in Mexico and dean of the Harvard School of Public Health” as saying, “As countries advance, they are realizing that creating universal healthcare systems is a necessity for long-term economic development.” A necessity? Gosh. It’s a wonder the United States ever became the world’s largest economy.

It speaks of such government guarantees as being popular, when what it really means to say is that people are dependent on the government for their health care and frightened to death that someone might take it away.

It laments the fact that the United States is an “outlier” because it fails to guarantee access to health care for all citizens, which “stands in stark contrast to America’s historic leadership in education…Long before most European countries, the United States ensured access to public schooling.” Yet it makes no mention of how U.S. students fare poorly in comparison to those in other advanced countries.

It devotes no time to the costs of such guarantees, other than to say that they are sometimes “more than twice what was expected.” But don’t worry, those costs are borne by the government. It does not say where governments get all that money. I guess we’ll never know.

Speaking of taxes, it makes no mention of how taxes suppress economic development. Evidently, unlike other taxes, those that support government-run health care systems do not incur the deadweight loss of taxation.

But the article was at its most ridiculous when it suggested that the health care sectors in poor countries like Rwanda and Ghana might possibly be ahead of the United States in any way whatsoever. As I have written about Rwanda:

The United States generates many of the HIV treatments currently fighting Rwanda’s AIDS epidemic, as well as other medical innovations saving lives there and around the world.  More than any other nation, we create the wealth that purchases those and other treatments for Rwandans and other impoverished peoples.  The United States is probably closer to providing universal access to medical care for its citizens — and, indeed, the whole world — than Rwanda.  Rwanda’s “universal” system leaves 8 percent of its population uninsured. Though official estimates put the U.S. uninsured rate at 15.4 percent, the actual percentage is lower; and again, uninsured Americans typically have better access to care than insured Rwandans.  The real paradox is here that Rwandan elites think the United States is doing something wrong.

Unfortunately, it’s not just the Rwandan elites. For my thoughts on how sensible people can make such insensible comparisons between the United States and other nations, read the rest of my post on Rwanda.

Soft Heart, Soft Head?

Yesterday, I came across a short Atlantic essay on the plight of children in Accra’s Abogbloshie slum entitled “The Hardware Scavengers of Ghana.” One particular sentence stood out for succinctly crystallizing the problem, and for its near-perfect internal inconsistency: “These kids are shortening their lives, but they don’t have any other options.”

You see, if they have no other options, the toxic job of electronics recycling—burning insulation off copper wires, applying degreasing solvents with bare hands, and so on—is extending their lives, not shortening them. According to the underlying article and interview on Mongabay.com, many of the recyclers come from Northern Ghana to escape poverty, maltreatment, “food insecurity,” and sectarian strife. The choice is not between recycling and school. It is between encountering carcinogens and neurotoxins or encountering violence, starvation, and death.

The Atlantic and Mongabay.com articles focus on the environmental and biological consequences of e-waste, and the responses they broach do the same. The Ghanian government might limit import of used electronics, but this would shrink the nation’s access to valued and productive communications equipment. Had it the capacity, the government might try to prevent dumping of e-waste where these recyclers can access it.

Solving the problem of e-waste might be a comfort to readers of the Atlantic concerned with their own environment and susceptibility to cancer. But if the statement about poor Ghanians’ options is true, such “solutions” would consign children and young men to death of starvation, violence, and war. That’s not the outcome I would prefer, even if it’s hidden from me.

A couple of lessons emerge from this compact tale. One is: never, ever invite me to your cocktail party. I will go about picking the scab off group consensus on faraway economic and social problems. And I will say, “See? That redness and pus? You haven’t fixed this.”

More importantly, the solutions that extend the lives of electronic waste recyclers may have nothing to do with controlling “e-waste.” These articles frame the problem as we would in the green, wealthy west. Economic development of all kinds in Ghana may give these youth better options than e-waste recycling, according them sustenance and safety, and perhaps eventually access to education.

I don’t know what improvements in trade policy (ours or theirs), rule of law, taxation or regulation might bring the wealth to Ghana that sustains its people better. I wish Ghana the relative luxury of controlling toxic waste, moving people from slum to suburbs, and so on. But if softness in our hearts leads us to soft-headedly sweep Ghana’s poorest from bad health conditions into conditions of death by starvation and violence, I think that would compound the tragedy.

Obama Says 20 Percent for Government Is Too Much!

While perusing Instapundit, I came across a post suggesting that President Obama thinks investment will suffer if government takes 20 percent of a company’s income. At first I thought this was a form of satire, but there is a real link to a speech that the President gave to the Parliament of Ghana. Indeed, the speech has several good comments:

Development depends on good governance. …Repression can take many forms, and too many nations, even those that have elections, are plagued by problems that condemn their people to poverty. No country is going to create wealth if its leaders exploit the economy to enrich themselves… No business wants to invest in a place where the government skims 20 percent off the top… No person wants to live in a society where the rule of law gives way to the rule of brutality and bribery. That is not democracy, that is tyranny, even if occasionally you sprinkle an election in there. And now is the time for that style of governance to end. 

My initial reaction, focusing on the passage about 20 percent being too much for government, is to ask why Obama wants higher tax rates in America? After all, he wants American small businesses to pay 40 percent, which is twice the burden he thinks is excessive for Ghanians. Upon further reflection, though, I wonder if the President is referring to corrupt bureaucrats asking for bribes. But, even if that is the case, why does that matter? Investors and entrepreneurs care about the amount of disposable income that is generated by an investment. Losing 20 percent to the tax collector has a negative impact on incentives, regardless of whether the money winds up in Treasury coffers or a bureaucrat’s pocket. In any event, it is good to see that the President recognizes that the economy suffers when government becomes too much of a burden. We just need to figure out how to convince him that the laws of economics work the same way in America as they do in Ghana.